Know Before You Expand Your Practice
Authored by: Frank Vinopal — Partner, CPA | Date Published: September 26, 2025
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For many private audiology practice owners, expansion is a natural next step. You’ve built a successful first location, and now you’re ready to grow. Whether that means adding a second clinic, broadening your patient reach, or creating more freedom in your own schedule, it’s an exciting milestone in your journey toward audiology success.
When it comes to growth, you have two main options: start a brand-new clinic from scratch (cold start) or buy a practice through acquisition. Both plans can work, but they have different pros and cons. Understanding these can help you choose the route that best aligns with your goals for profitability, patient satisfaction, and your own role as a business owner.
What Are The Benefits and Setbacks of a Cold Start?
There’s an appeal to building something from scratch. With a cold start, you get:
- Complete control over design and operations. You choose the location, layout, equipment, and brand.
- No inherited baggage. No existing staff challenges or outdated systems.
- Lower initial cost of ownership. A cold start avoids buyout costs, keeping initial ownership expenses lower.
But the challenges can be significant:
- The hidden costs. It’s easy to underestimate hidden costs, such as build-out, equipment setup, staffing, marketing, and cash flow gaps, which can add up quickly before revenue comes in.
- No existing patients. Establishing a loyal base takes time, leaving you with no immediate revenue.
- Slow ramp-up. Profitability often takes years, with ongoing capital needs in the meantime.
- Finding a provider and staff. Finding qualified providers and reliable staff can be challenging, often taking longer and costing more than new practice owners expect.
For owners who want to spend less time in patient care and more time growing the business, cold starts often feel like taking a step backward. That’s why many turn instead to buying a practice as a faster way to grow.
How Does Acquisition Give You a Head Start?
Acquiring an existing audiology practice accelerates growth by giving you a solid foundation from day one.
- Instant cash flow. Revenue starts immediately, thanks to an existing patient base.
- Established patients. A loyal database provides recurring appointments, upgrades, and referrals.
- Staff are already in place. Many practices include trained providers and front desk teams.
- Reduced marketing needs. Awareness already exists; your focus can shift to improving patient experience.
Of course, acquisition comes with its own considerations:
- Higher purchase price. The upfront cost is greater than a cold start.
- Due diligence is essential. Financials, patient records, and operations must be carefully reviewed.
- Staff integration. Retaining key employees and aligning cultures requires planning.
Still, the ability to scale faster and free up your own time often outweighs the challenges. With proper planning and modern tools such as audiology patient management software, the transition can be seamless.
How Do the Financials Compare?
At first glance, launching a practice from scratch may seem like the cheaper option. However, once you factor in the hidden costs, slow patient growth, and the heavy commitment required, it often proves far more draining than expected.
With an acquisition, the return is faster. You’re stepping into a practice that already generates revenue, which means cash flow from day one and a much shorter path to profitability.
A strong business plan for private practice is key to mapping out the financial impact of each approach so you can make the best decision for your future. Once your practice is up and running, how do you ensure that you can build long-term value? Consider our latest blog, The Audiologist’s Guide to Greater Practice Worth, to learn more.
What Steps Can You Take for a Smooth Acquisition?
If you’re leaning towards buying a practice, here’s how to maximize success:
- Review thoroughly. A comprehensive review of the practice’s financial health, patient database, and daily operations is critical before moving forward.
- Prioritize staff retention. A strong team makes a seamless transition and preserves patient satisfaction.
- Develop an integration plan. Align systems, workflows, and patient experience with your current location.
- Communicate your vision. Set expectations early so employees and patients feel secure and supported.
- Obtain resources. Utilize resources like ASHA Private Practice or work with an audiology practice coach to gain guidance on industry standards and best practices.
What’s the Bottom Line?
Expanding your audiology practice is an exciting milestone. While cold starts give you complete creative control, they often come at the expense of time, profitability, and your ability to step back from patient care.
Acquisition, though requiring a larger initial investment, offers the fastest path to growth, stability, and long-term success. By inheriting patients, staff, and infrastructure, you gain the freedom to focus less on day-to-day operations and more on the bigger picture—patient satisfaction, financial growth, and building the business you’ve always envisioned.
With the right acquisition strategy, your following location can become profitable faster, less stressful to run, and a stronger foundation for the future of your practice.
At MBE CPAs, we help audiology practice owners evaluate their options, choose the best path forward, and ensure their financials are aligned for long-term growth. Whether you’re weighing a cold start or an acquisition, our team can guide you toward the route that builds lasting value for both your business and your patients.